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[Encephalopathy after brain injuries during birth in the light of a 25-year follow-up].

In the years 1916-1989 104 men (68% boys examined in the 60th) of the average age of 36 underwent catamnestic examinations. They were stated in 1960-62, according to clinical documentation of delivery to have the birth brain injury. The main aim of the work was to try to explain whether the particular disturbances of children and teenagers with M.B.D. are only passing episodes or they transfer into the psychic disturbances when patients grow up, and also to find out if there is any relation between them. The results of the examination after 25 years proved but the organic irreversible damage of the central nervous system in 71% of men and in 60% of cases the birth injury was the only factor and in the rest ones it was one of many reasons. The clinical manifestation of the diagnosed organic brain damage after the birth injury in the case of grown-ups were: wrong developed personality mainly in the emotional sphere, psychosomatic diseases with aggravated vegetative reactions, incorrect results of additional tests and also disability to functioning in society with social unfitness. In the light of the examinations it seems that birth brain injury is a very important risk factor for unfitness to modern civilization.

Adjustment Disorders↗
PubMed1985

[Forensic psychiatry problems in depression].

Forensic complications involving criminal or civil law are generally rare in depressive disorders, but are of varied nature and of great consequence to the person concerned. Suicide, which is the problem of greatest practical importance may have far-reaching consequences with regard to legal insurance, apart from the medical responsibility or liability. From the point of view of civil law, moreover, the effects of depression on thought and action, as well as on free will with respect to legal capacity, testifiability, marriageability, actionability and potential considerations of interdiction ought to be examined. Last, but not least, consequences of a socio-legal nature may ensue. The spectrum of possible crimes by depressed subjects essentially comprises disease-characteristic offences, amongst which the desperate deed of extended suicide is foremost, as well as other criminal acts with a less direct connection to the depressive syndrome. Additional factors such as alcohol and medication may further complicate the relationship and also the assessment of culpability. In the forensic judgment of depressed subjects diagnostic classification is not alone decisive, but depends to a greater extent on the nature and severity of the psychopathological state and its influence on motivational aspects.

Automobile Driving↗
PubMed1998

Quality of life in patients with benign anorectal disorders.

BACKGROUND: Benign proctological conditions are very common in Western civilization. However, to date quality of life in these patients has not been evaluated comprehensively. The aim of this study was to investigate whether the Gastrointestinal Quality of Life Index (GIQLI) is a useful instrument for measuring quality of life in these patients, and subsequently to establish baseline values for different anorectal disorders. METHODS: The questionnaire was completed by 325 consecutive patients (182 men; mean age 49 years) seen at the proctology outpatient clinic. For further analysis patients were classified into nine subgroups according to the primary diagnosis: group 1, haemorrhoids (n=96); group 2, anal fissure (n=38); group 3, fistula in ano (n=22); group 4, severe constipation (n=14); group 5, faecal incontinence (n=35); group 6, symptomatic anterior rectocele (n=12); group 7, perianal abscess (n=7); group 8, perianal thrombosis (n=7); and group 9, miscellaneous conditions (e.g. skin tags, anal papillomas, mild constipation, rectal polyps) (n=94). The GIQLI scores were compared between the subgroups. In addition the GIQLI scores of age-matched healthy controls, derived from data in the literature, were compared with the patients' scores. RESULTS: The mean GIQLI score for all patients was 113 (78.5 per cent of the maximum score of 144). Mean scores for the nine diagnostic subgroups were: group 1, 120; group 2, 104; group 3, 119; group 4, 94; group 5, 93; group 6, 112; group 7, 115; group 8, 129; and group 9, 117. Age-matched controls from a series published previously had a significantly higher GIQLI score compared with all patients (P < 0.0001). However, only the subgroups of patients with miscellaneous conditions, fissures, severe constipation and faecal incontinence had a significantly poorer quality of life than age-matched healthy individuals. CONCLUSION: The GIQLI is a valuable instrument for measuring quality of life in patients with benign anorectal disorders. Although certain diseases do not seem to affect quality of life profoundly, certain subgroups of patients, most notably those with incontinence and severe constipation, are extremely compromised. Severely constipated individuals exhibit the same poor quality of life as patients with faecal incontinence.

Adolescent↗
PubMed1994

[Reported occupational diseases. A 5-year follow-up study from the county of Ribe].

The present study sought to examine the health-related, work-related, social and economic consequences of occupational disorders. The survey included 503 patients and was undertaken approximately five years after the disease was notified to the Registry of Occupational Diseases (Danish Working Environment services). The response rate was 80% with women accounting for 56% of the responding group. The mean age was 39.5 years. More than half of all respondents were unskilled workers. White-collar workers and civil servants constituted 14%. Musculo-skeletal disorders were the most frequently diagnosed condition. Forty percent of the occupational diseases were reported in the year in which symptoms arose, while 21% of the patients had been symptomatic for more than six years before the disease was notified. The study indicates that many patients' occupational diseases caused them significant social and medical consequences. During their often protracted illnesses, patients underwent numerous medical examinations and additionally contacted several agencies other than health care providers. Economic consequences for the patient were considerable: reduced earning capacity and expenses were only partially offset by the workers' compensation system. The impact on the health care system was also considerable: occupational disease sufferers averaged one week of hospitalization and 18 visits to a general practitioner or specialist.

Adult↗
PubMed2002

[Some aspects of the problem of competence, restricted competence in legislation of Ukraine].

Analized in the article are clauses of the Civil code, Civil legal code of Ukraine that contain information concerning the concepts "competence", "restricted competence". It is shown that the laws in force make no provision for restriction of competence in respect of those subjects with non-psychotic mental disturbances. At the same time, certain clauses of the Civil code of Ukraine do make provision indirectly for restriction of competence of persons, those with non-psychotic mental disorders included, under certain conditions.

Civil Rights↗
PubMed1987

Oculogyric crisis: a syndrome of thought disorder and ocular deviation.

In 3 patients who suffered oculogyric crises, mental changes accompanied upward deviation of the eyes. In 1 patient, whom we studied in detail, the mental disturbance consisted of a disorder of attention in which pathological fixation of a thought occurred. During the period of upward eye deviation, all functional types of conjugate eye movements were present in the upper field of gaze, suggesting an imbalance of the vertical gaze-holding mechanism. The eyes could be driven down only by a combined blink and downward saccade. Both the thought disorder and the ocular deviation responded promptly to anticholinergic agents. We propose that the disorders of thought and eye movement in oculogyric crisis are linked by a pharmacological imbalance common to both.

Adult↗
PubMed1985

[Exhibitionism--a criticism of only biologically oriented interpretations of this sexual disorder].

Attempts at explaining exhibitionism as being a mere relic of an instinct which--characteristic of the earliest phylogenetic stages--reappears in a limited number of males, fail to recognize the nature of this sexual disorder which is so frequent in our civilization. Such an explanation not only remains vague and speculative but deserves criticism also for being incomplete. The organisation of exhibitionism is more complex than that. There is a striking resemblance to certain rituals of negative tropism. The motives of the delinquents originate in a deeply rooted disbelief in ever being recognized in their masculinity. Thus there are episodes when the genitals are practically utilized: After an humiliation for instance, the exposure of the genitals is employed to alleviate conflicts in connection with strong feelings of inferiority. By means of the phallic demonstration the person concerned attempts to regain his self-respect and to establish for himself the prestige of a normal of even superior male.

Arousal↗